Booster seats and laws requiring their use are in the top tier of prevention interventions, since both offer net cost savings. A recent economical analysis by Ted Miller, PhD, et al, looked at their societal return on investment by comparing the direct costs of using and mandating booster seats with the savings of injuries prevented or mitigated.

The study centered on Partners for Child Passenger Safety (PCPS) data showing that moderate to severe injuries for children ages 4 to 7 using boosters with lap and shoulder belts are 59% lower than those using lap and shoulder belts alone. Researchers added the costs of a booster seat ($30), of maintaining and using a booster ($167, based on 4 hours per year for 4 years), and of a law mandating use (9.4 percent added to the direct cost of a booster) and the likelihood of related injuries, to the cost of related injuries. Analysts then spread out costs and benefits over the 4-year lifespan of a booster, discounting annual dollars for successive years.

With certain discounts, the savings come to $1854 over a 4-year period. Broken down, the savings include $245 in medical spending, $161 in other resource costs, $433 in work loss for parent(s), and $1,015 in the value of Quality of Life Years.

The study concluded that purchase, maintenance and use of belt-positioning boosters offer a 9.4 to 1 return on invest ment. When the costs of passing and implementing laws are added, there is still an 8.6 to 1 return. Further analysis demonstrated that even considering families who purchase multiple boosters for the same child, or the potential for early retirement of boosters, the findings still support the conclusions.

Belt-positioning boosters offer a sound return on investment, and booster seat usage legislation should be passed, publicized and enforced.